{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:43:55Z","timestamp":1786977835459,"version":"build-2736575974"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,8,22]],"date-time":"2021-08-22T00:00:00Z","timestamp":1629590400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Thiazolidinediones (TZDs) and glucagon\u2010like peptide\u20101 (GLP\u20101) receptor agonists are potential pharmacological treatment options for patients at risk of NAFLD. Therefore, we examined the association between the risk of NAFLD and the use of TZDs and GLP\u20101 receptor agonists compared with the use of sulfonylureas (SUs) and insulins. Additionally, we calculated the incidence of HCC in users of TZDs and GLP\u20101 receptor agonists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results<\/jats:title>\n                    <jats:p>We conducted a population\u2010based cohort study using primary care data from the Clinical Practice Research Datalink database (2007\u20102018). All patients aged \u226518 with a prescription of an oral glucose\u2010lowering agent or GLP\u20101 receptor agonist were included. The first prescription defined the start of follow\u2010up. The primary outcome was a new diagnosis of NAFLD. Cox proportional hazards regression was used to estimate HRs and 95% CIs of the primary outcome. Incidence rates of HCC were determined per 1,000 person\u2010years for all exposures. The study identified 207,367 adults with a prescription for a glucose\u2010lowering agent. The risk of NAFLD was lower in patients prescribed a TZD than in those prescribed an SU (adjusted HR [aHR], 0.32; 95% CI, 0.20\u20100.51). No difference in risk of NAFLD was observed comparing GLP\u20101 receptor agonist use with insulin use (aHR, 1.22; 95% CI, 0.91\u20101.63).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Results of our study endorse the use of TZDs for selected patients at risk of NAFLD but do not support previous findings regarding the beneficial effect of GLP\u20101 receptor agonists. The low number of events in several subgroups may affect the generalizability of the current findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.32012","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T15:30:48Z","timestamp":1623771048000},"page":"2467-2477","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":22,"title":["Thiazolidinediones and Glucagon\u2010Like Peptide\u20101 Receptor Agonists and the Risk of Nonalcoholic Fatty Liver Disease: A Cohort Study"],"prefix":"10.1097","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1904-2505","authenticated-orcid":false,"given":"Judith","family":"van Dalem","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy & Toxicology,Maastricht University Medical Centre+,Maastricht,the Netherlands"},{"name":"CARIM School for Cardiovascular Disease,Maastricht University,Maastricht,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna H. M.","family":"Driessen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy & Toxicology,Maastricht University Medical Centre+,Maastricht,the Netherlands"},{"name":"CARIM School for Cardiovascular Disease,Maastricht University,Maastricht,the Netherlands"},{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology,Utrecht Institute of Pharmaceutical Sciences,Utrecht,the Netherlands"},{"name":"NUTRIM School for Nutrition and Translational Research in Metabolism,Maastricht University,Maastricht,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"Burden","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Applied Biosciences,Institute of Pharmaceutical Sciences,ETH Zurich,Zurich,Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coen D. A.","family":"Stehouwer","sequence":"additional","affiliation":[{"name":"CARIM School for Cardiovascular Disease,Maastricht University,Maastricht,the Netherlands"},{"name":"Department of Internal Medicine,Maastricht University Medical Centre+,Maastricht,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf H.","family":"Klungel","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology,Utrecht Institute of Pharmaceutical Sciences,Utrecht,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy & Toxicology,Maastricht University Medical Centre+,Maastricht,the Netherlands"},{"name":"CARIM School for Cardiovascular Disease,Maastricht University,Maastricht,the Netherlands"},{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology,Utrecht Institute of Pharmaceutical Sciences,Utrecht,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8229-3331","authenticated-orcid":false,"given":"Martijn C. 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